Comparison of Mandibular Bone Mineral Densities in Dentate and Edentulous Patients

Purpose: In contemporary implant dentistry, bone mineral density (BMD) of the jaws is a patient‐associated prognostic factor. The aim of this study was to compare the mandibular body BMD of dentate and edentulous patients using the dual‐energy X‐ray absorptiometry (DXA) technique. Materials and Methods: A total of 39 patients, 20 dentate and 19 edentulous, were included in this cross‐sectional study. Mandibular body BMD was measured using the DXA technique. The variables were normally distributed; thus, the independent samples t‐test was used for the determination of statistical significance between the dentate and edentulous groups (age, body mass index [BMI], DXA). Chi‐square test was performed for identification of the gender differences between the groups. The Pearson correlation analysis was used to analyze the relationship between age, BMI, and mandibular body BMD. Note that p < 0.01 was accepted as the significance level. Results: There was no statistically significant difference between the dentate and edentulous groups in matching variables (age, BMI, and gender) (p > 0.01). There was a statistically significant difference regarding the mandibular body BMD in the dentate and edentulous group (p < 0.01) controlling for age, gender, and BMI. The edentulous group patients had higher mandibular body BMD values (1.27 ± 0.31 g/cm²) than those in the dentate group (0.94 ± 0.22 g/cm²). Conclusion: Comparison of the mandibular body BMD revealed that dentate patients had less dense bone than the edentulous patients. Further investigations are needed to determine the BMD of the jaws in different regions and for different systemic conditions.     

Maternal generalized anxiety disorder during pregnancy and fetal brain development: A comparative study on cord blood brain-derived neurotrophic factor levels

Objectives

The study aimed to investigate whether maternal GAD during pregnancy affects fetal circulating brain-derived neurotrophic factor (BDNF), which plays important roles in neuronal development, by comparing cord blood BDNF levels in newborn infants of women with and without GAD.

Methods

Study sample included 19 women with GAD and 25 women without any psychiatric disorder. GAD and other psychiatric diagnoses were screened by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The blood sample for the determination of BDNF level was obtained from the umbilical cord during delivery.

Results

Cord blood BDNF levels in newborn infants of healthy women were approximately two-fold compared to newborn infants of women with GAD, and the difference was statistically significant. The duration of GAD during pregnancy was the only variable correlating with cord blood BDNF levels.

Conclusions

The study results imply that prolonged maternal GAD during pregnancy may negatively influence neurodevelopment of the fetus through lower levels of circulating BDNF.     

The effect of different adhesive system applications on push-out bond strengths of glass fiber posts

PURPOSE

Over the past years, the adhesion of fiber posts luted with simplified adhesive systems has been a matter of great interest. The aim of this study was to assess the post retentive potential of a self-adhesive resin cement using different adhesive systems to compare the push-out bond strengths of fiber posts.

MATERIALS AND METHODS

The post spaces of 56 mandibular premolar roots were prepared and divided into 4 experimental groups and further divided into 2 subgroups according to testing time (n=7). The fiber posts (Rely X Fiber Post) were luted with a self-adhesive resin cement (RelyX Unicem) and one of the following adhesive systems: no adhesive, a total-etch adhesive resin (Single Bond), a two-step self-etch adhesive resin (Clearfil SE Bond) and a one-step self-etch adhesive resin (Clearfil S3 Bond). Each root was cut horizontally, and 1.5 mm thick six root segments were prepared. Push-out tests were performed after one week or three months (0.5 mm/min). Statistical analysis were performed with three-way ANOVA (α=.05).

RESULTS

Cervical root segments showed higher bond strength values than middle segments. Adhesive application increased the bond strength. For one week group, the total-etch adhesive resin Single Bond showed higher bond strength than the self-adhesive resin cement RelyX Unicem applied without adhesive resin at middle region. For 3 months group, the two-step self-etch adhesive resin Clearfil SE Bond showed the highest bond strength for both regions. Regarding the time considered, Clearfil SE Bond 3 months group showed higher bond strength values than one week group.

CONCLUSION

Using the adhesive resins in combination with the self-adhesive resin cement improves the bond strengths. The bond strength values of two-step self-etch adhesive resin Clearfil SE Bond improved as time passes.     

Axis I and Axis II diagnoses in women with PCOS

Objective

The objective was to determine the current prevalence of Axis I and Axis II psychiatric diagnoses in patients with polycystic ovary syndrome (PCOS).

Method

The study sample included 73 patients with PCOS and 73 control subjects. Psychiatric disorders were determined by structured clinical interviews.

Results

The rate of any Axis I psychiatric disorder (28.8% vs. 15.1%), social phobia (13.7% vs. 2.7%), generalized anxiety disorder (11.0% vs. 1.4%), any Axis II psychiatric disorder (23.3% vs. 9.6%) and avoidant personality disorder (12.3% vs. 1.4%) was significantly more common in the patient group compared to the control group.Of women with PCOS, 21 (28.8%) had at least one Axis I and 17 (23.3%) had at least one Axis II diagnosis. The most common Axis I disorder was social phobia (13.7%) and the most common Axis II disorder was avoidant personality disorder (12.3%) in women with PCOS. Social phobia, generalized anxiety disorder, and avoidant personality disorder were significantly more common in the patient group compared to the control group.

Conclusion

Our results suggest that a considerable proportion of women with PCOS also present with anxiety and personality disorders.     

Immunomodulatory therapy versus surgery for Rasmussen syndrome in early childhood

We examined seizure, cognitive, and motor outcomes in patients with Rasmussen syndrome or Rasmussen encephalitis (RS), after recent initiation of immunomodulatory therapies. Among 53 patients with a diagnosis of RS referred from all over Japan, 49 patients (male 22, female 27) with symptoms and findings characteristic of RS were evaluated. Regular intravenous immunoglobulin (IVIg) therapy was administered at a dose of 100 mg/kg/day, etc. Regular steroid pulse therapy was conducted with methylprednisolone at a dose of 30 mg/kg/day (children) or 1000 mg/day (adults) for 3 days. Tacrolimus was given at an initial dose of 0.1 mg/kg/day (children). Mean onset age was 8.7 ± 10.5 years. Seizure-free rate was 71% after treatment by functional hemispherectomy (FH), and response rate for seizures was 81% by regular steroid pulse therapy, 42% by tacrolimus therapy, and 23% by regular IVIg therapy. Rate of patients with IQ higher than 80 (R80) was 50% by regular steroid pulse therapy, 43% by regular IVIg therapy, 29% by tacrolimus therapy, and 0% by FH. R80 after regular steroid pulse therapy was 100% in patients without MRI lesions, and 37% in those with advanced MRI lesions. Improvement of motor function (paresis) was observed only by immunomodulatory therapy. Motor function was aggravated in 100% of patients treated by FH, 62% by regular IVIg, and 10% by regular steroid pulse therapy. We suggest a new treatment strategy for RS using early immunomodulatory therapy: initiation of regular steroid pulse therapy after early diagnosis indicated by biomarkers, then switching to tacrolimus therapy after several months.     

Breast cancer related lymphedema in patients with different loco-regional treatments

IntroductionLymphedema, a sequela of breast cancer and breast cancer therapy, changes functional abilities and may affect a patient's psychosocial adjustment and overall quality of life. Aim of this prospective observational study was to determine the rate of mid-term and late time period lymphedema in breast cancer patients with different loco-regional treatments, and factors associated with lymphedema.Materials and methodsPatients surgically treated for early-stage breast cancer were prospectively enrolled in the study. Demographic, clinical, pathological, and loco-regional treatments data of patients and lymphedema rates were recorded. Patients were divided into six groups regarding different loco-regional treatments. Pre- and postoperative (12 months, and median 64 months after surgery) circumferences of arms were recorded.Results218 patients, all female with a median age of 48 (19–82) years, were included in the study. The numbers of patients in breast conservation surgery group (BCS) (N = 104), mastectomy group (N = 114), sentinel lymph node biopsy group (SLNB) (N = 80), axillary lymph node dissection group (ALND) (N = 138), group with radiotherapy (RT) (N = 88) and group without radiotherapy (N = 130). Incidence of lymphedema after surgery in mid-term period was 24.8%. The rate of lymphedema at 64 months median follow-up time was 7.3%. (BCS: 11.1%, 4.2% and 0.5%; Mastectomy: 15.0%, 3.2% and 1.4%; SLNB: 8.0%, 1.9% and 0.5%; ALND: 18.0%, 5.3% and 1.4%; RT: 14.7%, 6.3% and 1.4%; without RT: 11.4%, 2.1% and 0.5%). When we excluded patients with both mid-term and late term lymphedema, only four patients developed lymphedema at late time, then re-calculated late term lypmhedema rate was 1.8%. The factors affecting the lymphedema was ALND and radiotherapy (RT) and no lymphedema was detected in patients underwent breast conserving surgery and SLNB. Age and body mass index were not related to lymphedema at any time.ConclusionThe incidence of lymphedema gradually increased in time and a quarter of patients experienced the complication at the end of year. The rate of lymphedema in patients with ALND was significantly higher than patients with SLNB alone. If RT added to SLNB the lymphedema rate was getting higher than SLNB alone. In all patients lymphedema rate was decreased one year after the surgery and further decreased at median 64 months follow-up time period.